A unique partnership to support private efforts to provide mental health services to veterans and their families could provide a model for similar efforts should federal officials decide to expand privately provided health care as part of reform of the VA health system, according to a new RAND Corporation report.

The Welcome Back Veterans Initiative, a joint project of philanthropic groups and major academic medical centers, has provided an array of patient care, education and other services to veterans and their families.

Backed by Major League Baseball and the Robert R. McCormick Foundation, the Welcome Back Veterans Initiative awarded grants totaling $5.4 million between 2011 and 2013 to support returning service members, veterans and their families. During that period, the Initiative funded six academic medical centers to expand access and improve the quality of community-based mental health care for veterans and their families.

Each site provided a different set of services, including programs to provide clinical services to aid veterans and their families, inform both the public and veterans about issues faced by former military members, education and training to veterans and their family members, trainings for civilian providers, and develop partnerships with the VA and veteran's groups.

"As the Veterans Health Administration looks for ways to improve services offered to the nation's veterans, the experience of the Welcome Back Veterans Initiative provides important insight about how the private sector can help," said Terri Tanielian, the report's lead author and a senior social research analyst at RAND, a nonprofit research organization.

Significant numbers of military personnel who served in the wars in Iraq and Afghanistan suffer from mental health issues such as post-traumatic stress, anxiety, trauma and traumatic brain injury. Mental health care is critical for them and their families as the veterans return to their community.

RAND researchers assessed the activities within the Welcome Back Veterans Initiative by gathering information from each of the participating medical centers about the services provided and visiting each site to observe operations and interview staff.

The six programs studied included the BraveHeart Southeast Veterans Initiative at Emory University, Duke University Veteran Culture and Clinical Competencies, the Home Base Program at Massachusetts General Hospital, the Military Support Programs and Networks at the University of Michigan, the Program for Anxiety and Traumatic Stress Studies at Weill Cornell Medical College and the UCLA Welcome Back Veterans Family Resilience Center.

Despite the well-documented needs of veterans and their families for high-quality mental health services, the sites reported some difficulty engaging veterans as they encountered hurdles finding information on where veterans reside and how best to reach them.

In addition, many veterans were unaware of health services outside the military or VA health systems and had concerns that nonmilitary providers would not understand the military culture.

Although the Welcome Back Veterans Initiative as a whole sought to address these barriers, many individual programs used a combination of creative approaches to reach out and engage veterans and their families. Some used paid advertising through a variety of media, while others did face-to-face outreach at community events organized for veterans.

In addition, each of the program's six sites worked to build relationships with local Veterans Affairs health providers or military bases, with varying levels of success. Strong personal relations were often the key to close associations, such as when staff members had affiliations at both the academic institution and the local VA facility.

While the Welcome Back Veterans Initiative launched an array of services, RAND researchers caution that the six centers all depend on outside funding to sustain operations. Several of the Welcome Home Veterans sites have sought additional support from foundations or government grants, as well as exploring possible service contracts.

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The study, "Enhancing Capacity to Address Mental Health Needs of Veterans and Their Families: The Welcome Back Veterans Initiative," is available at http://www.rand.org. More information about the Welcome Back Veterans Initiative is available at http://www.welcomebackveterans.org

Support for the analysis was provided by the Robert R. McCormick Foundation. Other authors of the report are Laurie T. Martin and Caroline Epley.

RAND Health is the nation's largest independent health policy research program, with a broad research portfolio that focuses on health care costs, quality and public health preparedness, among other topics.

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